Multiple Sclerosis

Guest Author - Monica J. Foster

Multiple sclerosis (MS) affects the ability of nerve cells in the brain and spinal cord to communicate with each other. The way nerve cells communicate is by sending electrical signals down long fibers called wrapped in an insulating substance called myelin. In MS, the body's own immune system harm and damage the myelin. When myelin is lost, the axons can no longer effectively conduct signals. The name multiple sclerosis refers to scars, called scleroses or lesions, particularly in the white matter of the brain and spinal cord. Quite a bit is known about the mechanisms involved in the disease process, yet the cause remains unknown. Genetics or infections are among the possible causes theorized. Different environmental risk factors have also been researched.

Almost any neurological symptom can appear with the disease, and is often progressive. Any symptom can impact an individual in a physical or cognitive way, leading to disabilities. MS takes several forms, with new symptoms occurring either in short bursts or slowly building and accumulating over a period of time in more progressive forms. Between attacks, symptoms may go away completely, but can cause permanent neurological problems, especially as the disease is in its advanced stages.

There is no known cure for multiple sclerosis at this time. However, treatments do make an attempt to: return functioning in the limb and thought processes after an attack, prevent new attacks from coming, and prevent disability. MS medications can have adverse effects or be poorly tolerated as well, and many patients pursue alternative treatments. However, alternative treatments still lack adequate scientific proof of effectiveness. The prognosis of MS is difficult to predict. It all depends on the type of the disease, the individualís disease characteristics, initial symptoms and the degree of disability the person endures as time advances. Life expectancy of patients is 5 to 10 years lower than that of the unaffected population.

Early in the course of MS, symptoms are often brief and transientóimpaired function caused by a particular episode, or relapse, tends to improve, in what is called a "remission." Remissions may be partial or total. However, over the course of years, incomplete recovery from relapses may occur. It is important to realize that, although it is a common cause of disability among young to middle-aged individuals, MS can be highly unpredictable and doesnít necessarily disable, nor does it always shorten life span significantly.

The average age is 33 for the first occurrence of symptoms, but MS may show up as early as childhood and as late as age 60 or beyond. MS affects almost twice as many women as men for some reason. Approximately 350,000 people in the U.S. have MS. It is estimated to affect about 3 million people worldwide.

Since the 1930s, the frequency of MS has been studied closely. However, despite improved diagnostic tests and better treatment regimens, the number of new cases annually does not appear to have increased.
The cause of MS remains elusive, even after many years of intensive research. The most widely accepted hypothesis right now is that an infection triggers a response in a personís autoimmune system. Autoimmunity implies a personís immune-defense system erroneously and inappropriately attacks normal tissues.

It can be a challenge to diagnose MS. Doctors must document carefully the occurrence of two or more episodes of impaired function, occurring at different times, while excluding all other possibilities. The fact that MS affects primarily the CNS white matter means it can be easier visualize very accurately areas of inflammation and damage via magnetic resonance imaging (MRI). MRI is an invaluable aid to diagnosis, although the MRI pictures by themselves arenít sufficient. MRI is also used to identify new relapses of MS. By the same token, cerebrospinal fluid typically shows chemical alterations that may support an MS diagnosis. However, a diagnosis canít always be concluded without the right clinical history and neurological examination.

Although the cause of MS remains elusive, drug therapies have been developed to reduce the number of relapses by 30 percent or more. Laboratory and clinical studies of many other possible treatments are underway, which is a very hopeful indicator of more effective therapies. In addition to these disease-modifying agents, treatment often includes medications used purely for relief of painful and paralyzing symptoms, as well as physical and occupational therapies.

Planning an exercise program in the early stages of MS, as well as modifying activities as MS flares and/or progresses, is also key. While multiple sclerosis may make a person feel theyíve lost some sense of control, it is important to stay on top of things where there is palpable control, such as following a healthy lifestyle of good nutrition, stopping smoking, and getting enough rest and relaxation. Some have found water aerobics and yoga to be helpful to add to their daily activity and relaxation regimens.

Stress, temperature extremes and illness can sometimes aggravate MS, so learning techniques to relax; sleeping for at least six to eight hours with naps are directed by your doctor may prove helpful. Temperature sensitivity is a problem with people with MS, so avoid extreme cold or heat. Dress warmly in layers so you donít get too hot and can remove clothing as needed. Dress in clothing that breathes, deflects moisture and protects delicate skin.

The uncertainties of MS make psychological and emotional support a key component for remaining positive and healthy as well. Support groups, whether health-based or faith-based, have proven to be a significant help to have peers who understand. Loved ones of someone going through MS needs support as well, so if you are going through MS, know that your loved ones and you are all going through something out of the normal routine for your family. It is okay to feel negativity and stress, but the healthier and more emotionally centering the activities the entire family can get involved in, the better everyone involved will feel and be able to help each other through.